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Updated: May 30, 2026

Precision Measurements and Parametric Models of Vertebral Endplates

Precision Measurements and Parametric Models of Vertebral Endplates

Published on: September 17, 2019

Cervical vertebrae maturation method morphologic criteria: poor reproducibility.

Trenton S Nestman¹, Steven D Marshall, Fang Qian

¹Department of Orthodontics, University of Iowa, Iowa City, USA.

American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics

|August 2, 2011

Summary

This summary is machine-generated.

The cervical vertebrae maturation (CVM) method for predicting mandibular growth has poor reproducibility due to difficulties classifying individual vertebral patterns, particularly C3 and C4. This limits its use as a strict clinical guideline in orthodontic treatment planning.

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Area of Science:

Orthodontics and Dental Anthropology
Radiographic Assessment of Skeletal Maturation

Background:

The cervical vertebrae maturation (CVM) method is widely used to predict peak mandibular growth.
Previous studies reported high reproducibility, but potential methodologic errors were not fully addressed.
Recent investigations indicate poor reproducibility of the CVM method after eliminating identified errors.

Purpose of the Study:

To investigate the reproducibility of individual vertebral patterns within the CVM method.
To identify which specific CVM vertebral patterns can be reliably classified by clinicians.

Main Methods:

Ten orthodontists evaluated cervical vertebrae C2-C4 morphology on 30 radiographs using CVM criteria.
Fleiss kappa statistic assessed interobserver agreement for individual morphological assessments.
Kendall coefficient of concordance measured interobserver agreement for derived CVM stages.

Main Results:

High agreement was found for lower border classifications (flat/curved) of C2-C4.
Low agreement was observed for vertebral body shapes (trapezoidal, rectangular, square) of C3 and C4.
Overall reproducibility was poor, with ~30% of cases yielding incompatible criteria for CVM staging; intraobserver agreement was 62% (excluding inconclusive) and interobserver agreement was moderate (Kendall's W=0.45).

Conclusions:

Difficulty in classifying C3 and C4 vertebral body shapes significantly contributes to the CVM method's poor reproducibility.
The CVM method's current limitations make it unreliable as a strict clinical guideline for timing orthodontic treatment.